Diabetic learns to control his body

This article submitted by Erin Aagesen on 7/6/00.
Daily injections of insulin: morning, noon, evening, and night. Scheduled meals, with allotted types and amounts of food. Eat when you aren't hungry. Only eat prescribed amounts when you feel famished.

This is the typical way to treat diabetes, a disease which affects almost 16 million Americans, nearly six percent of the population. Because their pancreas is unable to produce insulin, which cells need to absorb sugar, diabetics typically use doses of insulin, and a regimented diet to control the amount of sugar in their blood.

"It doesn't matter if you're hungry or not," explained Kevin Odell, who was diagnosed with Type I diabetes when he was 15 years old. "You have to eat, and you have to take your shots."

Kevin, who has treated his diabetes for 15 years with a fixed routine, wanted a vacation from the disease. So, in April, he spent nine days at the University of Vienna Medical School in Austria, accompanied by his wife, Laura, taking a course entitled Functional Insulin Treatment.

"Vienna was a life-changing experience," Kevin is quick to say now.

Getting to Vienna
Kevin's regard for the program has increased dramatically from his first exposure.
A friend sent him a clipping from a newspaper in Mound, Minn., about a woman who took her son to the program in Vienna. Kevin quickly dismissed her as an overactive mother. He still didn't believe in the treatment when he actually met Sheryl Hill at a diabetes conference in Hawaii in January.

Kevin, who is a doctor of pharmacy (Pharm.D.), couldn't imagine what he could learn from the program. Laura is also a Pharm.D. and works at the Paynesville Area Health Care System (PAHCS), where she does diabetes education, among other things.

But, deciding he had nothing to lose, Kevin signed up for the program. "I thought I knew everything before I went, but I was wrong," Kevin said on the couple's porch overlooking Rice Lake.

The program, which has been around since the 1980s, is offered in English only once a year. Each year, Hill, who needed a translator when she took her son to the program, organizes a group of 15 people who take the class.

Kevin and Laura say they got their best glimpse of Vienna on their way from the airport to their hotel. After that, they spent eight hours a day in a classroom at the medical school.

Insulin games
The class started with a basic education about diabetes, information with which Kevin and Laura were already familiar. The instructors had reviewed the medical history of all the participants prior to the start of the course.

For Kevin, the benefit of the class was when it turned from theory to practice. To learn how their blood sugar levels in-creased and how much insulin they needed, the students played insulin games.

They ate, or fasted, and monitored their blood sugar levels. One day, Kevin tested his blood sugar 32 times. For the week, he averaged testing himself 15 times a day. "To learn what your body does, you test yourself a lot," Kevin said.

Laura even felt a little left out while everyone else tested their blood and administered injections.

On feasting night, the members of the class had their first chance to eat whatever they desired. "I think all the kids in the group had regular pop for the first time," Laura said. Because sugar intake is normally regimented for diabetics, they had only had diet soda previously. A 37-year-old man in the group had birthday cake for the first time in 25 years.

The group also fasted for 36 hours to learn what their body did without food intake.

From all of this testing, Kevin learned how his body functioned. "I learned more about myself," he explained. "Instead of learning more about the general way to manage diabetes, I learned about me."

"It was like we were lab rats," he continued. "We were the scientists, and we were the lab rats."

Now he knows that eating a piece of bread will raise his blood sugar level by 50. An injection of insulin will reduce his blood sugar level by 40. Now he can calculate his blood sugar based on his food consumption, his insulin injections, and the amount of his physical activity.

One of the last insulin games involved targeting blood sugar levels. The patients were told to get their blood sugar level around 100, and then eat and raise it above 250. Then they were supposed to get their level back to 100. Kevin started at 102, reached 258, and stopped at 99.

"That's what truly amazed me about this program," he said. "I can manipulate (my blood sugar) to get wherever I want to."

More shots, more freedom
By following functional insulin treatment, Kevin is completely responsible for controlling his blood sugar, but he has more freedom. "I eat what I want, when I want it," he said.

He still gives himself two injections of insulin a day as background for his body. In addition, he will inject himself after he eats, as needed. So, nibbling while working at the Jaycee's cheese curd stand during Town and Country Days isn't a problem anymore. He just gives himself another injection of insulin.

"If I eat ten times today, I give myself ten injections," he explained.

While the idea of ten injections a day might sound threatening to those of us who tremble for weeks before getting our only shot of the year, Kevin, as a diabetic, has been injecting himself daily for 15 years. He is so used to the pin pricks of the tiny needle that he says brushing his teeth in the morning is more of a nuisance than an injection.

"It's a good trade-off," he said of the extra injections, "because it's a little more discomfort for a lot more freedom."

While Kevin will never escape his diabetes, which has no known cure, his new treatment provides a reprieve from the regimented diet and schedule, which really is what he wanted to escape. "I had this perception that diabetes was a huge burden on my life, and I got a vacation from that because I no longer think of my diabetes as a problem," he explained.

A Fit USA convert
As a Pharm.D. at PAHCS, Laura helps manage the blood sugar levels of patients every day. While some people are more comfortable with this approach, having a professional track their health and assist in making decisions, Kevin and his classmates can manage themselves, without any help. "If their blood sugar is out of whack, they can fix it," Laura explained.
"I know myself better than anyone else ever could," said Kevin.

The program is not for everyone, they agreed. To do functional treatment, a patient needs to have a good understanding of their disease, must be motivated to manage all the details of treatment, and must be willing to assume responsibility for their health. They also need to take an intensive training course like Kevin's.

That is a problem. While the treatment has been around almost 20 years, it is still offered only in Europe. Only one class of 15 is taught in English each year.

Fit USA, a nonprofit group founded by Hill, is trying to bring the treatment to the United States. Hill contacted diabetic specialists across Minnesota, but got little interest in the program.

A group of physicians from Miami has embraced the project. Once they are trained, they will be conducting a session for a group of 12 diabetics (six from Miami and six from Minnesota) every three months. They also will be training other health care professionals.

Skeptical of this program six months ago, Kevin is now serving on the board of directors of Fit USA. He notes that everyone who has been to Vienna has continued with the program (except for one diabetic who died in an accident).

Kevin, who works for a pharmaceutical research company, will be helping to conduct a study of the program in Miami. Documented proof of the treatment's effectiveness is needed before insurance companies will reimburse for the course. The Odells paid $1,500 out of pocket for the course in Vienna, plus travel expenses.

On a hemoglobin test used to measure the level of blood sugar over time, Kevin used to score close to eight, well above the four to six range that is considered normal. After nine days in Vienna, he was already down to 6.9.

Now he can keep his blood sugar more stable and within the normal range of 70-115, avoiding the roller coaster of high or low blood sugar levels. Laura compares the lethargy caused by the high blood sugar level of a diabetic to the traditional Thanksgiving Day nap caused by an enormous meal of turkey and stuffing.

Kevin has more energy and even sleeps better when maintaining a stable blood sugar level, Laura added. "Kevin is a lot (happier), a lot more even tempered," she said. "I can tell he's a different person since we've been back."

Being healthier now should help Kevin avoid complications later in life. "The main thing," he said, "is it's going to give me a better quality of life."